| 彭伟,陈津,魏伟,等.血清KL-6预测肺癌患者放疗后发生放射性肺炎风险的研究[J].中华放射医学与防护杂志,2017,37(12):891-895.Peng Wei,Chen Jin,Wei Wei,et al.Serum KL-6 predicts the risk of pneumonitis induction after radiotherapy of human lung cancer[J].Chin J Radiol Med Prot,2017,37(12):891-895 |
| 血清KL-6预测肺癌患者放疗后发生放射性肺炎风险的研究 |
| Serum KL-6 predicts the risk of pneumonitis induction after radiotherapy of human lung cancer |
| 投稿时间：2017-06-03 |
| DOI：10.3760/cma.j.issn.0254-5098.2017.12.002 |
| 中文关键词: 肺癌 涎液化糖链抗原 放射性肺炎 放射治疗 |
| 英文关键词:Lung cancer KL-6 Radiation pneumonitis(RP) Radiation therapy |
| 基金项目:国家临床重点专科建设项目 |
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| 摘要点击次数: 4072 |
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| 中文摘要: |
| 目的 探讨放射治疗前后血清涎液化糖链抗原（KL-6）水平改变在预测肺癌患者发生放射性肺炎（radiation pneumonitis，RP）中的意义。方法 对87例接受胸部放射治疗的Ⅰ~Ⅲ期肺癌患者临床资料进行严格随访，动态观察其放疗前及治疗开始后3个月内血清中KL-6、转化生长因子β1（TGF-β1）和乳酸脱氢酶（LDH）的改变，结合其临床症状及影像学改变，探讨其在预测或早期诊断RP的作用。结果 87例肺癌患者依据临床症状及胸部CT表现，发现有13例被诊断为并发≥2级RP。该13例患者和74例0~1级RP患者在放疗前血清KL-6平均水平分别为（247±105.44）和（209±71.09）U/ml，≥2级RP组患者放疗后3个月内血清KL-6最高水平达（456±202.84）U/ml，放疗后与放疗前比值达（2.01±1.04）倍；而0~1级RP患者放疗3个月内KL-6最高水平为（222±80.42）U/ml，放疗后与放疗前比值为（1.13±0.60）倍，两组间差异有统计学意义（t=2.901，P<0.05）；而血清TGF-β1与LDH在放疗前后没有明显变化。对放疗后与放疗前血清KL-6比值升高进行受试者工作特征曲线（ROC）分析显示：以1.435为临界值，血清KL-6比值升高诊断≥2级RP的敏感性为0.923%，特异性为0.851%。进一步多因素Logistic回归分析显示，KL-6比值升高（OR=12.886，95%CI=3.372~49.247，P=0.002）为≥2级RP的独立危险因素。结论 放疗过程中血清KL-6比值升高≥1.435倍与肺癌患者发生≥2级RP相关，可作为接受放射治疗的肺癌患者发生≥2级RP的预测因素。 |
| 英文摘要: |
| Objective To explore the irradiation-increased krebs von den lungen-6 (KL-6) in predicting radiation pneumonitis (RP) after lung cancer radiotherapy. Methods A total of 87 hospitalized patients with Ⅰ-Ⅲ stages of lung cancer from June 2015 to December 2015 were followed up, and their clinicopathological data and serum KL-6, transforming growth factor-beta 1 (TGF-β1)and lactate dehydrogenase (LDH)before and 3 months after radiotherapy were analyzed to determine their role in predicting RP induction in lung cancer. Results Among the 87 lung cancer patients based on clinical symptoms and chest CT, 13 patients were diagnosed with ≥ 2 grape RP. Before radiotherapy, the average levels of serum KL-6 were (247±105.44) U/ml in 13 patients with ≥ 2 grape RP and (209±71.09) U/ml in 74 cases 0/1 grape RP, respectively. Within 3 months after radiotherapy, the highest level of KL-6 approached to (456±202.84) and (222±80.42) U/ml with increase ratios of 2.01±1.04 and 1.13±0.60 in the ≥ 2 grape RP and 0/1 grape RP, respectively. The difference of KL-6 levels between these two groups was significant (t=2.901,P<0.005). While the levels of TGF-β1 and LDH did not change. ROC analysis showed that the sensitivity of the ratio of serum KL-6 increased after radiotherapy was 0.923% and the specificity was 0.851% at 1.435 as the critical value. Furthermore, the multi-variate logistic regression analysis showed that the ratio of KL-6 increased as an independent risk factor of ≥ 2 grade RP in lung cancer (OR=12.886, 95%CI=3.372-49.247, P=0.002). Conclusions The increased ratio (≥ 1.435) of KL-6 is closely correlated with the ≥ 2 grape RP in lung cancer, which could be used as a predictor of ≥ 2 grape RP in lung cancer. |
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